Moral Controversy and Working with Colleagues with a Shared Ethical/Moral Outlook: A National Survey of US Primary Care Physicians

Noncarbapenems for the Treatment of Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase-Producing Bacteria

 Objectives: Urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are resistant to many conventional therapies, including third-generation cephalosporins. Carbapenems are considered first-line agents for ESBL infections, but their use is associated with increased multidrug resistance and should be reserved when absolutely necessary. Because of the increased rates...

OPEN: Developing and Piloting a Tool to Identify Food Insecurity in Older Adults

Objective: The literature shows that food insecurity (FI) can negatively affect the trajectory of many chronic illnesses. FI can be acutely severe for older adults, but screening for FI is not regularly performed in the hospital setting. Our goal was to develop a tool to screen for FI upon...

Weight-Bearing Physical Activity Influences the Effect of Vitamin D on Bone Turnover Markers in Patients with Intellectual Disability

Objectives: Individuals with intellectual disabilities (IDs) are at increased risk for low bone mass and fragility fractures, and those who are nonambulatory may be at even higher risk. Patients with IDs often are vitamin D deficient, but there is little information concerning how vitamin D treatment of patients with...

Prevalence and Predictors of Pulmonary Embolism in Hospitalized Patients with Syncope

Objectives: Approximately one in six patients hospitalized with syncope have pulmonary embolism (PE), according to the PE in Syncope Italian Trial study. Subsequent studies using administrative data have reported a PE prevalence of <3%. The aim of the study was to determine the prevalence and predictors of PE in...

Assessing the Availability of Pharmacotherapy Options for Tobacco Cessation in Tennessee’s Substance Use Facilities

Objectives: Smoking is deadly and exacerbates comorbid health conditions, especially among those with co-occurring substance use disorders. Tennessee does not require substance abuse treatment facilities to concurrently provide tobacco-cessation treatment options or limit smoking on facility property as a standard for licensure. This study examines the relation between Tennessee...

Choice of Intravenous Crystalloid Fluid and Mortality in Critically Ill Adult Patients

Objectives: Intravenous balanced crystalloid fluid therapy may improve mortality and other outcomes in critically ill adult patients, but data are conflicting. We conducted a meta-analysis and literature review to evaluate the impact of intravenous balanced crystalloid, as compared with normal saline, fluid therapy on outcomes in critically ill adult...

Commentary on “An Updated Approach to Evaluation and Treatment of Helicobacter pylori Infection”

This issue of the Southern Medical Journal contains an important and timely review of Helicobacter pylori diagnosis and treatment.1 Since its discovery in 1983, H. pylori infection has been found to be the main cause of peptic ulcer disease, chronic gastritis, gastric cancer, and mucosa-associated lymphoid tissue...

An Updated Approach to Evaluation and Treatment of Helicobacter pylori Infection

Helicobacter pylori is a chronic bacterial infection that can lead to peptic ulcer disease, chronic gastritis, and gastric cancer. Its prevalence in the United States is lower than in most of the world, although specific populations are at particular risk for disease-related complications, including those with lower socioeconomic status...

Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults in Baltimore, Maryland

Objectives: Adults with perinatally acquired human immunodeficiency virus (PHIV) infection may be at increased risk for nonacquired immunodeficiency syndrome (AIDS) diseases, including systemic hypertension (HTN). The purpose of this study was to examine the prevalence of HTN among young adults with PHIV compared with recently infected and uninfected young...

Patients on Involuntary Hold Status in the Emergency Department

Summary of Selected Healthcare Encounters among a Selection of Patients with Myotonic Muscular Dystrophy

Objective: Research has not examined the use of health care by patients with myotonic muscular dystrophy (MMD), but it would provide insights into this population, which is prone to comorbidities and high service needs. This study is an analysis of this understudied subgroup, using a unique linked dataset to...

Fetal Hemoglobin Modulators May Be Associated With Symptomology of Football Players with Sickle Cell Trait

Objectives: This study investigates whether genetic modifiers previously shown to influence adult fetal hemoglobin (HbF) levels and glucose-6-phosphate dehydrogenase deficiency were associated with variable symptomology in a small sample of collegiate football players with sickle cell trait.Methods: Survey data on self-assessed symptoms and genotype data from five single nucleotide...

Otolaryngology: Breadth, Depth, Challenge, and Choice

Otolaryngology – head and neck surgery (ORL-HNS) is not only one of the most competitive disciplines for students seeking residency, but it also is one of the most complex, challenging, and flexible fields in medicine, especially in surgery. Unfortunately, with only 106 accredited allopathic otolaryngology residency programs and 179...

Use of Cardiac Troponin Testing in the Outpatient Setting

Objectives: Cardiac troponin (cTn) measurement is useful for diagnosing myocardial infarction (MI), particularly in the inpatient setting. A growing body of literature suggests that cTn may be useful for evaluating chronic conditions in the outpatient environment; however, little is known regarding cTn ordering patterns in this setting. We sought...

Commentary on “Otolaryngology: Breadth, Depth, Challenge, and Choice”

In this issue of the Southern Medical Journal, Sataloff and colleagues take on the challenge of providing an “overview of modern otolaryngology” for medical students and medicalstudent advisors.1 After an introduction in which they astutely point out that many medical students matriculate at schools unassociated with academic otolaryngology programs,...

Commentary on “Is Endurance Exercise Safe? The Myth of Pheidippides”

I commend Ms Christine Rutlen and Dr David Rutlen for their dedication in developing this interesting treatise on the effects of long-distance running on the human body.1 They have striven to survey the pertinent literature with respect to the various organs potentially affected and to address how a question...

Open Access: Inconsistencies in Colonic Tattooing Practice: Differences in Reported and Actual Practices at a Tertiary Medical Center

Objectives: Accurate localization of a colonic lesion is crucial to successful resection. Although colonic tattooing is a widely accepted technique to mark lesions for future identification surgery or repeat colonoscopy, no consensus guidelines exist. The objective of this study was to determine whether the current tattooing practice at a...

A Brief Review of the Pharmacology of Hyperkalemia: Causes and Treatment

Hyperkalemia is a common problem in both inpatients and outpatients. Many disease states (eg, chronic kidney disease) and medications may precipitate hyperkalemia. There are several drugs now available to treat hyperkalemia. Many of these drugs are relatively new. This review provides information regarding drug-induced causes of hyperkalemia and provides...

Outcomes in an Interdisciplinary Diabetes Clinic in Rural Primary Care

Objective: The purpose of this study was to evaluate the effectiveness of an interdisciplinary diabetes team model of care in assisting patients to achieve improved glucose control in a primary care rural setting.Methods: A family medicine clinic at a rural university medical center developed an interdisciplinary diabetes team clinic...